Search results for "Brain injury"

Individualized Thresholds of Hypoxemia and Hyperoxemia and their Effect on Outcome in Acute Brain Injured Patients: A Secondary Analysis of the ENIO …

2023

Background: In acute brain injury (ABI), the effects of hypoxemia as a potential cause of secondary brain damage and poor outcome are well documented, whereas the impact of hyperoxemia is unclear. The primary aim of this study was to assess the episodes of hypoxemia and hyperoxemia in patients with ABI during the intensive care unit (ICU) stay and to determine their association with in-hospital mortality. The secondary aim was to identify the optimal thresholds of arterial partial pressure of oxygen (PaO2) predicting in-hospital mortality. Methods: We conducted a secondary analysis of a prospective multicenter observational cohort study. Adult patients with ABI (traumatic brain injury, suba…

2015

AbstractAccumulating evidence suggests a pivotal role of PDGFRß positive cells, a specific marker for central nervous system (CNS) pericytes, in tissue scarring. Identification of cells that contribute to tissue reorganization in the CNS upon injury is a crucial step to develop novel treatment strategies in regenerative medicine. It has been shown that pericytes contribute to scar formation in the spinal cord. It is further known that ischemia initially triggers pericyte loss in vivo, whilst brain trauma is capable of inducing pericyte detachment from cerebral vessels. These data point towards a significant role of pericytes in CNS injury. The temporal and spatial dynamics of PDGFRß cells a…

Secondary Growth of a Primary Brain Tissue Necrosis from a Focal Lesion

1994

Traumatic brain injury is associated with the development of secondary brain damage, such as brain edema, intracranial hypertension, and cerebral ischemia [1]. A novel aspect is that a primary necrosis of brain parenchyma evolving from a focal cerebral insult may be subjected to secondary growth. Experiments utilizing different methods of brain injury have consistently confirmed an increase in size of the resulting tissue necrosis within 24 h, amounting to 50% in rats [3, 7, 10] and even 300% in rabbits [11]. It is not clear yet, however, whether the phenomenon reflects a delayed but irreversible primary process which is resistant to treatment or a manifestation of secondary brain damage, t…

Exploring the Virchow-Robin spaces function: A unified theory of brain diseases.

2016

Background: Cerebrospinal fluid (CSF) transport across the central nervous system (CNS) is no longer believed to be on the conventional lines. The Virchow-Robin space (VRS) that facilitates CSF transport from the basal cisterns into the brain interstitial fluid (ISF) has gained interest in a whole new array of studies. Moreover, new line of evidence suggests that VRS may be involved in different pathological mechanisms of brain diseases. Methods: Here, we review emerging studies proving the feasible role of VRS in sleep, Alzheimer's disease, chronic traumatic encephalopathy, and traumatic brain injury (TBI). Results: In this study, we have outlined the possible role of VRS in different path…

The Blood–Brain Barrier as a Target in Traumatic Brain Injury Treatment

2014

Traumatic brain injury (TBI) is one of the most frequent causes of death in the young population. Several clinical trials have unsuccessfully focused on direct neuroprotective therapies. Recently immunotherapeutic strategies shifted into focus of translational research in acute CNS diseases. Cross-talk between activated microglia and blood–brain barrier (BBB) could initiate opening of the BBB and subsequent recruitment of systemic immune cells and mediators into the brain. Stabilization of the BBB after TBI could be a promising strategy to limit neuronal inflammation, secondary brain damage and acute neurodegeneration. This review provides an overview on the pathophysiology of TBI and brain…

A PCA Interpretation of the Glasgow Coma Scale in the Trauma Brain Injury PECARN Dataset

2018

CT scan is strongly recommended for a patient affected by head trauma, but he/she must absorb a certain amount of radiations. For this reason, the physician tries to avoid such a practice for pediatric patients. The symptoms analysis, visual/tactile inspection, and reactions to appropriate stimuli from the physician could induce him/her to put the patient in a period of observation instead of performing an immediate CT scan. As a consequence, the correct evaluation of those symptoms is a crucial task. For this reason, the Pediatric Glasgow Coma Scale (PGCS) plays a fundamental role, because it is a numeric scale regarding the patient’s mental status. It is computed as the sum of the score f…

A Decision-Tree Approach to Assist in Forecasting the Outcomes of the Neonatal Brain Injury

2021

Neonatal brain injury or neonatal encephalopathy (NE) is a significant morbidity and mortality factor in preterm and full-term newborns. NE has an incidence in the range of 2.5 to 3.5 per 1000 live births carrying a considerable burden for neurological outcomes such as epilepsy, cerebral palsy, cognitive impairments, and hydrocephaly. Many scoring systems based on different risk factor combinations in regression models have been proposed to predict abnormal outcomes. Birthweight, gestational age, Apgar scores, pH, ultrasound and MRI biomarkers, seizures onset, EEG pattern, and seizure duration were the most referred predictors in the literature. Our study proposes a decision-tree approach b…

Needs of family members of patients with acquired brain injury

2011

Authors' reply-multi-organ ultrasonography: a stethoscope for the body

2018

We read with great interest the letter from Sakka et al . (1) commenting our article (2) on comprehensive haemodynamic monitoring in patients with acute respiratory distress syndrome (ARDS) and traumatic brain injury (TBI). We agree with the authors that haemodynamic monitoring has to be implemented in patients with ARDS complicating TBI.

Acute respiratory distress syndrome in traumatic brain injury: how do we manage it?

2017

Abstract: Traumatic brain injury (TBI) is an important cause of morbidity and mortality worldwide. TBI patients frequently suffer from lung complications and acute respiratory distress syndrome (ARDS), which is associated with poor clinical outcomes. Moreover, the association between TBI and ARDS in trauma patients is well recognized. Mechanical ventilation of patients with a concomitance of acute brain injury and lung injury can present significant challenges. Frequently, guidelines recommending management strategies for patients with traumatic brain injuries come into conflict with what is now considered best ventilator practice. In this review, we will explore the strategies of the best …